廖小杰 王向东

【摘要】 目的：探讨分析在小儿静脉吸入复合麻醉使用右美托咪定和咪达唑仑的效果。方法：回顾性分析2019年3月-2020年3月于本院就诊的60例静脉吸入复合麻醉患兒的资料，按照麻醉用药将其分为研究组和对照组，各30例。研究组用右美托咪定麻醉，对照组用咪达唑仑麻醉，对两组的不同时间点（诱导前，麻醉诱导后1、3 min，插管后1、3 min，拔管后1、5 min）的血压、心率、SpO2值进行对比;比较两组拔管后0、5、10、15、20、30 min的躁动发生率和麻醉、手术、苏醒时间。结果：诱导前，麻醉诱导后1、3 min，插管后1、3 min，拔管后1、5 min，两组收缩压、舒张压、心率、SpO2水平比较，差异均无统计学意义（P>0.05）。拔管后5、10、15、20 min，研究组躁动率均较对照组低（P<0.05），拔管后0、30 min，两组躁动率比较，差异均无统计学意义（P>0.05）。结论：在小儿静脉吸入复合麻醉使用右美托咪定，不会对患儿的血压、心率、血氧饱和度造成较大的影响，拔管后苏醒期躁动率较低，因此可在临床应用。

【关键词】 小儿静脉吸入复合麻醉 右美托咪定 咪达唑仑 苏醒期躁动 血压

[Abstract] Objective： To explore and analyze the effect of Dexmedetomidine and Midazolam on agitation during recovery of intravenous inhalation anesthesia in children. Method： The data of 60 children with intravenous inhalation anesthesia admitted to our hospital from March 2019 to March 2020 were retrospectively analyzed， they were divided into study group and control group according to anesthetic drugs， 30 cases in each group. Anesthetized with Dexmedetomidine as the research group， anesthetized with Midazolam as the control group. At different time points （before induction， 1， 3 min after anesthesia induction and intubation， 1， 5 min after extubation） of the two groups blood pressure， heart rate， and SpO2 levels ??were compared; the incidence of agitation at 0， 5， 10， 15， 20， 30 min after extubation and the time of anesthesia， operation and recovery were compared between the two groups. Result： Before induction， 1 and 3 min after induction of anesthesia， 1 and 3 min after intubation， 1 and 5 min after extubation， there were no statistically significant differences in systolic blood pressure， diastolic blood pressure， heart rate and SpO2 levels between two groups （P>0.05）. 5， 10， 15， 20 min after extubation， the rate of agitation in the study group was lower than those in the control group （P<0.05）， there was no significant difference in the rate of agitation between the two groups at 0 and 30 min after extubation （P>0.05）. Conclusion： The use of Dexmedetomidine for intravenous inhalation anesthesia in children will not have a significant impact on the childrens blood pressure， heart rate， and oxygen saturation. The agitation after extubation is also significantly reduced， so it can be used clinically.

[Key words] Pediatric intravenous inhalation anesthesia Dexmedetomidine Midazolam Agitation during recovery Blood pressure

First-authors address： Dongguan Maternal and Child Health Hospital， Dongguan 523002， China

doi：10.3969/j.issn.1674-4985.2021.06.040

麻醉是手术治疗必不可少的步骤，良好的麻醉可以保证手术、治疗的顺利进行，而有些药物会造成患者在麻醉过程中出血压不稳定，心律失常，患者提前清醒，或者清醒较晚等问题[1]。静脉吸入复合麻醉是静脉麻醉和吸入麻醉的集合，静脉麻醉药具有起效快、对呼吸道无刺激等特点，常用于诱导麻醉，而吸入麻醉药由于其麻醉深度易于控制，术后恢复快，常用于全麻的维持[2]。而对于麻醉药物的选择是保证麻醉效果，降低苏醒期躁动，对患者心率、血压、血氧饱和度不造成影响的主要环节[3]。临床……